• The Journal of Korean Society for Radiation Therapy
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• v.28 no.2
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• pp.87-99
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• 2016

Purpose : This study will evaluate the clinical utility by applying clinical schematic that uses monoenergy or dual energy as according to the location of tumors to the stereotactic radiotherapy to compare the change in actual dose given to the real tumor and the dose that locates adjacent to the tumor. Materials and Methods : CT images from a total of 10 patients were obtained and the clinical planning were planned based on the volumetric modulated arc therapy on monoenergy and dual energy. To analyze the change factor in the tumor, Comformity Index(CI) and Homogeneity Index(HI) and maximum dose quantity were each calculated and comparing the dose distribution on normal tissues, $V_{10}$ and $V_5$, first ~ fourth ribs closest to the tumor ($1^{st}{\sim}4^{th}$ Rib), Spinal Cord, Esophagus and Trachea were selected. Also, in order to confirm the accuracy on which the planned dose distribution is really measured, the 2-dimensional ion chamber array was used to measure the dose distribution. Results : As of the tumor factor, CI and HI showed a number close to 1 when the two energies were used. As of the maximum dose, the front chest wall showed 2% and the dorsal tumor showed equivalent value. As of normal tissue, the front chest wall tumors were reduced by 4%, 5% when both energies were used in the adjacent rib and as of trachea, reduced by 11%, 17%. As of the dose in the lung, as of $V_{10}$, it reduced by 1.5%, $V_5$ by 1%. As of the rear chest wall, when both energies were used, the ribs adjacent to the tumors showed 6%, 1%, 4%, 12% reduction, and in the lung dose distribution, $V_{10}$ reduced by 3%, and $V_5$ reduced by 3.1%. The dose measurement in all energies were in accordance to the results of Gamma Index 3mm/3%. Conclusion : It is considered that rather than using monoenergy, utilizing double energy in the clinical setting can be more effectively applied to the superficial tumors.

• Clinical and Experimental Pediatrics
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• v.50 no.9
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• pp.891-895
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• 2007

Purpose : Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system and mostly develops after viral illness or vaccinations. We investigated the clinical differences and neurologic outcomes according to the distribution of the lesions on brain MRI. Methods : The study group was composed of 21 patients from January 1995 to August 2003 in Kyunghee University hospital. We grouped the patients according to the MRI findings as follows. Group I (14 cases): Multi- or unifocal lesions only in the cerebral white matter. Group II (7 cases): lesions in the gray matter with or without white matter involvement. Results : 1. Preceding events were as follows: no defined prodrome (38.1%), upper respiratory tract infection (28.6%), nonspecific febrile illness (19.0%), gastointestinal disturbance and vaccination. 2. Presenting symptoms were as follows: seizures (76.2%), headache/vomiting (47.6%), altered consciousness (38.1%), hemiparesis, cerebellar ataxia, visual disturbance and facial nerve palsy. 3. Laboratory findings were as follows: CSF pleocytosis (76.2%), leucocytosis (38.1%) and elevated CSF protein (28.6%). 4. Fifteen patients were recovered completely without neurological sequelae. Three patients in group I and 1 patient in group II had intractable seizures. Two patients in group I and 2 patients in group II had motor disturbance. Conclusion : There were no statistically significant differences in preceding events, presenting symptoms, and neurological outcomes according to the distribution of the lesions on brain MRI. However, the ADEM have quite diverse clinical manifestations and neuroimage findings. MRI plays an important role in making diagnosis of the patients who are suspected of ADEM.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.1
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• pp.625-636
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• 2017

Dyslipidemia, hypertension, and diabetes are well-established risk factors for cardio-cerebrovascular disease (CVD). Although the prevalence of dyslipidemia among Korean adults is very high, its management is known to be poor. The aim of this study was to assess the prevalence, awareness, treatment, and control rates of dyslipidemia among adults aged 30 years and older in Gangwon-do, Korea. Analysis included 58,121 adults (29,123 males and 28,998 females) participating in the 2013-2014 Korea National Health Screening Program (KNHSP). Dyslipidemia was defined according to the treatment criteria rather than the diagnostic criteria in Korea. Therefore, high-low-density lipoprotein cholesterol (LDL)-cholesterolemia was deemed present in individuals with LDL-cholesterol levels that exceeded the appropriate risk-based threshold. The age-standardized prevalence was highest in dyslipidemia (32.5%), followed by hypertension (25.1%), and diabetes (9.4%). The awareness rate was 76.7% for hypertension and 74.7% for diabetes, but only 10.6% for dyslipidemia. The lowest patient treatment was found for dyslipidemia (9.4%). The control rate among those undergoing treatment was highest for hypertension (75.8), followed by dyslipidemia (63.3%), and diabetes (43.9%). The higher CVD-risk categories showed lower control rates of hyper-LDL-cholesterolemia. The prevalence of dyslipidemia was higher than hypertension and diabetes, but awareness and treatment rates were lower. Our findings indicate there is a wide gap between the prevalence of dyslipidemia and subsequent treatment, which suggests that effective strategies are required to improve dyslipidemia management. It would be worthwhile to strengthen the follow-up management of patients with dyslipidemia in the KNHSP, especially for the high risk group of CVD.

• Journal of Nutrition and Health
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• v.31 no.9
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• pp.1411-1421
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• 1998

The purpose of this study was to investigate the effects of apo E polymorphisms and dietary counseling on the levels of plasma lipids in hyperlipidemic patients. The changes of serum lipids were assessed f3r 34 hyperlipidemic out-patients who changed their basal diet containing 20.1% fat(236.0mg cholesterol/day), 15.7% protein, and 64.2% carbohydrate to a diet containing 18.3% fat(109.8mg cholesterol/day), 15.7% protein, and 66.0% carbohydrate for 12 weeks. At the beginning of this study, the levels of plasma LDL-cholesterol were high according to apo E genotypes in the following order : E2/3

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2000.10a
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• pp.278-283
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• 2000

As information communication technology developed we could check our blood pressure, pulsation electrocardiogram, SpO2 and blood test easily at home. To check our health at ordinary times is able though interlocking the house medical instrument with the wireless public data network This service will help the inconvenience to visit the hospital everytime and will save the individual's time and cost. In each house an organism data which is detected from the human body will be transmitted to the distance hospital and will be essentially applied through wireless public data network The medical information transmit system is utilized by wireless close range network It would transmit the obtained organism signal wirelessly from the personal device to the main center system in the hospital. Remote telemetry system is embodied by utilizing wireless media access protocol. The protocol is embodied by grafting CSMA/CA(Carrier Sense Multiple Access with Collision Avoidance) protocol falling mode which is standards from IEEE 802.11. Among the house care telemetry system which could measure blood pressure, pulsation, electrocardiogram, SpO2 the study embodies the ECC(electrocardiograph) measure part. It within the ECC function into the movable device and add 900㎒ band wireless public data interface. Then the aged, the patients even anyone in the house could obtain ECG and keep, record the data. It would be essential to control those who had a health-examination heart diseases or more complicated heart diseases and to observe the latent heart disease patient continuously. To embody the medical information transmit system which is based on wireless network. It would transmit the ECG data among the organism signal data which would be utilized by wireless network modem and NCL(Native Control Language) protocol to contact through wireless network Through the SCR(Standard Context Routing) protocol in the network it will be connected to the wired host computer. The computer will check the recorded individual information and the obtained ECC data then send the correspond examination to the movable device. The study suggests the medical transmit system model utilized by the wireless public data network.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.1
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• pp.13-22
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• 2015

Purpose : We investigated the safety of Intrabeam$^{TM}$ system, X-ray unit for Intraoperative Radiotheray (IORT) by measuring surface dose using Optically Stimulated Luminescent Dosimeter(OSLD). Materials and Methods : 30 patients were selected, who were in breast cancer patients and had an operation of breast conserving surgery (BCS). At the inner surface of tumor bed, 20 Gy were described, and 5 Gy at 1cm depth from the inner surface. Along the size of tumor bed which could be decided after resection of tumor, the size of applicator were determined. Usual treatment time were from 18 to 40 minutes. For the measurement of surface doses, OSLD were placed at superior(U1,2), inferior(D1,2), lateral(L1,2) and medial(M1,2) directions from the center of applicator. Each direction, two OSLD were placed at 0.5 cm and 1.5 cm from the center. Mean, maximum, and minimum doses were analyzed to be compared. Results : Mean values were U1 $2.23{\pm}0.80Gy$, U2 $1.54{\pm}0.53Gy$, D1 $1.73{\pm}0.63Gy$, D2 $1.25{\pm}0.45Gy$, L1 $1.95{\pm}0.82Gy$, L2 $1.38{\pm}0.42Gy$, M1 $2.03{\pm}0.70Gy$, and M2 $1.51{\pm}0.58Gy$. Maximum values were 4.34 Gy at U1, and Minimum values were 0.45 Gy at M2. 13.3 % of patient (4pts out of 30) were reported that surface dose were over 4 Gy. Conclusion : The fact that skin dose of all patients were less than 5 Gy based on OSLD measurement showed the safety of Intrabeam$^{TM}$ system. In the relatively small breast volume, the tendency that surface dose was increased had been shown, which was analyzed by the data of patients who irradiated over 4Gy at skin surface. Therefore, for appropriate indication for IORT, it is suggested that breast volume as well as the size and position of tumor should be carfully considered.

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.76-83
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• 1995

Background: Despite advances in chemotherapy, the treatment of inoperable non-small cell carcinoma of the lung remains poor. According to the recent reports, the response rates of mitomycin, vinblastine, and cisplatin(MVP) chemotherapy are higher than those of other cisplatin based polychemotherapy and MVP chemotherapy can be used as neoadjuvant chemotherapeutic regimen. But the overall response rates of MVP chemotherapy range from 17 to 53 percent, so we studied the effect of MVP chemotherapy in advanced non-small cell lung cancer. Method: We treated forty patients with stage III or IV non-small cell lung cancer with two courses of MVP chemotherapy($8mg/m^2$ of mitomycin on day 1, $6mg/m^2$ of vinblastine on day 2 & day 14, and $100mg/m^2$ of cisplastin on day 1) at 4 weeks interval. Then all patients were evaluated the response of chemotherapy 4 weeks later, and received further chemotherapy, palliative radiotherapy or supportive therapy according to the patient's condition. We also determined the median survival time and prognostic factors. Results: 1) Nine patients(23%) had a partial reponse, 23 patients(57%) had a stable disease, and disease progressed in 8 patients(20%). There were no patients with complete response. 2) The overall median survival time was 36 weeks(range, 9 to 119+ weeks). The median survival time of responder(partial response) and non-responder(stable and progressed) groups were 60 weeks(range, 36 to 82+ weeks) and 31 weeks(range, 9 to 119+ weeks) respectively(p=0.03). 3) The median survival time of the female group was 71 weeks and significantly prolonged in comparision with 35 weeks of the male group(p=0.01). But, the other prognostic factors didn't affect the survival time and response rate. 4) The median survival times of chemotherapy group and chemotherapy with palliative radiotherapy group were not significantly different. Conclusion: MVP combined chemotherapy is unsatisfactory in improving survival in advanced non-small cell lung cancer. Therefore, further studies are needed to find more active new agents and to estabilish the efficacy of the combined treatment with radiotherapy and/or surgery.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.14-21
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• 1996

Objectives: Although outbreak of MDR Tb has been a recent problem in western countries, it has been a longstanding problem in Korea. The poor outcome of MDR Tb is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. Thus, to improve the outcome of MDR Tb, it is crucial to make individualized adequate prescription based on the knowledge of the patterns of resistance to each drugs in the community as well as the natural history. The purpose of present study is to evaluate the clinical features of Korean MDR Tb patients including patterns of drug resistance and success rate of treatment which was prescribed according to the sensitivity tests. Methods: Retroscpective analysis of 71 Korean patients with MDR Tb was made. All strains isolated from patients showed resistence to at least two first line drugs. Patients profile, previous treatment history, patterns of drug resistance, outcome of treatment was analysed. Initial treatment regimen was selected according to the previous treatment history and was modified according to the sensitivity reports. The regimen was composed to include at least 4 sensitive drugs when possible. Results: The patients showed resistance to 4.1 drugs on average. 90% of them were resistant to INH and RFP. Among 71 patients, 35 patients(49%) had cavitary lesions in CXR. Treatment outcome was analysed in 55 patients. 35 patients(67%) were improved after treatment and 18 patients(33%) showed treatment failure. 5 patients showed primary resistance. Treatment outcome could be evaluated in 4 of them and all showed improvement after treatment. 14 patients(20%) had to change their regimens due to drug side effects. The most frequent side effect was elevation of liver enzymes(6 patients). Others included dizziness, hyperuricemia, tinnitus, skin rash, GI troubles. More than 50% of side effects developed within 3 months. In repeated drug sensitivity test, the concordance rate of resistance to INH was 100% and RFP 98%. EMB, PZA showed 80% concordance rate. But in the other drugs, the concordances were less than 50%. Operation was done in 5 patient - 1 patients as a adjunctive means of chemotherapy -. In that case, negative conversion of sputum AFB was done. Conclusion: 2/3 patients of multidrug-resistant tuberculosis were improved by appropriate prescription and regular medication suggesting that more aggressive management and monitoring is indicated in multidrug-resistant tuberculosis.

• Journal of Korean Academy of Nursing
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• v.23 no.4
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• pp.631-648
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• 1993

This study is a descriptive study to provide basic data related to types of uniforms worn by nurses. Nurses, other medical center personnel, patients and their famillies were asked for their opinion on changing nurses’ uniforms and how the image of nurses is 1 elated to the type of uniform worn by the nurses. The data for this study were collected during the period from Feb. 25, 1993 to Mar. 26, 1993 at Y-University Medical Center from 132 nurses, 137 other medical center personnel, 117 patients and their families. The instruments used for this study were the Nurses’ Image Scale(NIS) developed by Bown(1986), and an instrument to measure opinions of uniform and cap using photographs of nurses’ uniforms that was developed by the researcher through a literture review. Data were analyzed using the SPPS / PC package, Statistics used for analysis were frequencies, percentages, paired t -test, and oneway ANOVA The results of this study are summarized as follows ; 1. Of the nurses, 84.3%, along with, 51.5% of the medical center personnel, 39.1% of the patients and their families agreed to a change in the color of nurses uniforms. 2. Similarly, 87.4% of the nurses,27.7% of the medical center personnel, 19.3% of the patients and their families were in favor of nurses not wearing caps. 3. Only 11.8% of nurses answered that a white uniform was important to the professional image of nursing. Only 2.4% of the nurses answered that a cap was very important to the professional image of nursing. 4. Only 1.6% of the nurses answered that a white uniform and cap were important to show the role of nurses in the twenty first century. 5. About 1/3, 36.5%, of the medical center personnel, the patient and their families answered that changing the color of the nurses' uniform will make a change in the image of nurses. 6. A White uniform and cap were seen as being im-portant in distinguishing nurses from other medical personnel in the hospital by 76.5% of the medical personnel, the patients and their families. 7. Nurses gave high marks to the idea of no cap regardless of the color of the uniform which would still portray the symbol of the nurses’ role, identity and would differentiate the role from other jobs. The patients and their families gave high marks to a white uniform with cap. 8. Generally, nurses, medical center personnel and patients and their families thought that a colored uniform with cap presented a good image of nurses. 9. There was a significant difference in the response among the three groups(F=24.65, P〈.001) to the figure in a white uniform with a cap, and the patients and their families thought it was the best portrayal of the image of nurses. There was a significant difference among the three groups(F=9.03, P〈.001) to the figure in a white uniform with no cap and the nurses indicated that it was the beat portrayed of the image of nurses. There was no significant difference among the three groups to the figure in a colored uniform with cap. There was a significant difference(F=17.50, P〈. 001) to the figure in a colored uniform with no cap, and the nurses indicated that it was the best portrayal of the image of nurses. In summary, the nurses wanted to change the color of uniform and not to wear a cap. But many of the medical center personnel, patients and their families indicated they did not agree with this idea. Therefore, changing the type of uniform worn by nurses should be done only after consideration has been given to the relation of the change to the professional role of nurses and the image of nurses held people in general. Suggestions arising from this study are as follows : 1. The relation between the role of nurses and their uniform was surveyed, and these results can be used as data when considering a change in uniforms. 2. A change in uniforms should be tried based on the norm established about uniforms. 3. The nurses did not want to wear a cap, but before a decision is definitely made it is necessary to study the philosophy related to the symbol of the cap because the figure of a nurse with a cap portrayed a positive image of the nurses. If the cap is kept, the symbol of the cap should be redefined. 4. In this study, only the image related to the uniform was examined, but in future studies it will be necessary to examine the practicality of various types of uniforms.

• Journal of Korean Academy of Nursing
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• v.20 no.3
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• pp.430-458
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• 1990

Care is a central concept of nursing. Nursing would not exist without caring. Care and quality of life are closely related. Human behavior is a manifestation of culture. We can say that caring and nursing care are expression of culture. The nurse must understand the relationship of culture with care for ensure quality nursing care. But knowledge of cultural factors in nursing is not well developed. Time and in - depth study are needed to find meaningful relationships between culture and care. Nurses recognized the importance of culturally appropriate nursing There are two care systems in culturally based nursing. The folk care system and the professional nursing care system. The folk care system existed long before the professional nursing care system was introduced into this culture. If the discrepancy between these two care systems is great, the client may receive inappropriate nursing care. Culture and subcaltures are diverse and dynamic in nature. Nurses need to know the caring behaviors, patterns, and their meaning in their own culture. In Korea we have taken some first step to study cultural nursing phenomena. It is not our intent necessarily to return to the past and develop a nationalistic of nursing, but to identify the core of traditional caring and relate that to professional nursing care. Our Assumptions are as follows : 1) Care is essential for human growth, well being and survial. 2) 7here are diverse and universal forma, expressions, patterns, and processes of human care that exist transcul - turally. 3) The behaviors and functions of caring differ according to the social structure of each culture. 4) Cultures have folk and professional care values, beliefs, and practices. To promote the quality of nursing care we must understand the folk care value, beliefs, and practices. We undertook this study to understand caring in our traditional culture. The Goals of this study were as follows : 1) To identify patterns in caring behavior, 2) To identify the structural components of caring, and 3) To understand the meaning and some principles of caring. We faised several questions in this study. Who is the care-giver? Who is the care-receipient? Was the woman the major care -giver at any time? What are the patterns in caring behavior? What art the priciples underlying the caring process? We used an interdisciplinary team approach, composed of representatives from nursing and anthropology, to contribute in -depth understanding of caring through a socicaltural perspeetive. A Field study was conducted in Ro-Bong, a small agricultural kinship village. The subjects were nine women and one man aged be or more years of age. Data were collected from january 15 to 21, 1990 through opem-ended in-depth interviews and observations. The interview focused on caring behaviors sorrounding birth, aging, death and child rearing. We analysed these data for meaning, pattern and priciples of caring. In this report we describe caring behaviors surrounding childbirth. The care-givers were primarily mothers- in -low, other women in the family older than the mother - to- be, older neighbor woman, husbands, and mothers of the mother-to- be. The care receivers were the mother-to-be the baby, and the immediate family as a component of kinship. Emerging caring behavior included praying, helping proscribing, giving moral advice(Deug - Dam), showing concern, instructing, protecting, making preparations, showing consideration, touching, trusting, encouraging, giving emotional comfort, being with, worrying about, being patient, preventing problems, showing by an example, looking after bringing up, taking care of postnatal health, streng thening the health condition, entering into another's feelings(empathizing), and sharing food, joy and sorrow The emerging caring component were affection, touching, nurtuing, teaching, praying, comforting, encouraging, sharing. empathizing, self - discipline, protecting, preparing, helping and compassion. Emerging principles of. caring were solidarity, heir- archzeal relationships, sex - role distinction. Caring during birth expresses the valve of life and reflects the valued traditional beliefs that human birth is given by god and a unique unifying family event reaching back to include the ancestors and foreward to later generations. In addition, We found positive and rational foundations for traditionl caring behaviors surrounding birth, these should not be stigmatized as inational or superstitious. The nurse appropriately adopts the rational and positive nature of traditional caring behaviors to promote the quality of nursing care.